TREATMENT OF PAIN FOLLOWING TRAUMATIC LES IONS OF THE BRACHIAL-PLEXUS

The occurrence of severe pain is one of the most disabling symptoms af ter the traumatic lesion of the brachial plexus. Avulsion of one or mo re cervical roots of the brachial plexus is the main cause of severe p ain, known as deafferentation pain. Lesion of the dorsal horn of the c ervical spinal cord due to root avulsion may lead to important patholo gical changes and scarring that are responsible for the induction of p ain sensations. Different medical and surgical treatment modalities ha ve been established to relief such pain after brachial plexus injury. In contrast to drug therapy, which usually offers only limited benefit , surgical treatment over the last years has shown positive results. C oagulation of the dorsal root entry zone (DREZ) is one of the most eff icient surgical treatments for these patients. Understanding of the pa thophysiological changes and different pain mechanisms induced by the traumatic injury of the brachial plexus is fundamental for the plannin g and step-wise treatment of such patients.